1. Toxicology exam Regarding Toxicology exam; CA MTUS Chronic Pain Medical Treatment Guidelines state that a urine analysis is recommended as an option to assess for the use or the presence of illegal drugs, to assess for abuse, to assess before a therapeutic trial of opioids, addiction, or poor pain control in patients under on-going opioid treatment. Since the opioids have been non-certified; the medical necessity of UDS has not been established. Recommend non-certification. 2. follow up appointment
INTRODUCTION: Delirium refers to confusion or acute confusional state of mind. It can be caused by physical illness or mental illness .delirium is most common in elderly patients. Basically delirium is condition which results in confusion, also includes changes in behavior, thinking, attention and mood. Difference between delirium, dementia and Alzheimer’s disorder: People suffering from dementia are highly susceptible to delirium but dementia should not be confused with delirium. In dementia changes